Sickness behavior is not all about the immune response: Possible roles of expectations and prediction errors in the worry of being sick

Brain, Behavior, and Immunity
Julie LasselinJohn Axelsson

Abstract

People react very differently when sick, and there are only poor correlations between the intensity of the immune response and sickness behavior. Yet, alternative predictors of the individual differences in sickness are under-investigated. Based on the predictive coding model of placebo responses, where health outcomes are function of bottom-up sensory information and top-down expectancies, we hypothesized that individual differences in behavioral changes during sickness could be explained by individual top-down expectancies and prediction errors. Twenty-two healthy participants were made sick by intravenously administering lipopolysaccharide (2 ng/kg body weight). Their expectations of becoming sick were assessed before the injection. Participants having lower expectations of becoming sick before the injection reacted with more emotional distress (i.e., more negative affect and lower emotional arousal) than those with high expectations of becoming sick, despite having similar overall sickness behavior (i.e., a combined factor including fatigue, pain, nausea and social withdrawal). In keeping with a predictive coding model, the "prediction error signal", i.e., the discrepancy between the immune signal and sickness expectancy, p...Continue Reading

Citations

Feb 11, 2020·Frontiers in Behavioral Neuroscience·Eric C ShattuckThankam S Sunil
Aug 6, 2019·Frontiers in Psychiatry·Sven Benson, Sigrid Elsenbruch
Jan 26, 2021·Brain, Behavior, and Immunity·Lina S HanssonJulie Lasselin
Mar 12, 2021·Frontiers in Psychiatry·Caroline J Smith, Staci D Bilbo

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